<section class="content-header">
	<h1> Create Jobseeker Form <small>Preview</small></h1>
	<ol class="breadcrumb">
		<li>
			<a href="#"><i class="fa fa-dashboard"></i> Home</a>
		</li>
		<li>
			<a href="#">Create jobseeker form</a>
		</li>
		<li class="active">
			New jobseeker
		</li>
	</ol>
</section>
<form role="form" action="<?php echo base_url(); ?>control-jobseekers/insert-jobseeker" method="post">
	<section class="content">
		<div class="row">
			<!-- left column -->
			<div class="col-md-6">
				<!-- general form elements -->
				<div class="box box-primary">
					<div class="box-header">
						<h3 class="box-title">New jobseeker</h3>
					</div><!-- /.box-header -->
					<!-- form start -->

					<div class="box-body">

						<div class="form-group">
							<label for="email">Email <span class="required">*</span></label>
							<input type="email" class="form-control" id="email" name="email" placeholder="Email" value="<?php echo set_value('email'); ?>" required="required">
							<?php echo form_error('email'); ?>
						</div>
						<div class="form-group">
							<label for="title">Title <span class="required">*</span></label>
							<select name="title" class="form-control">
								<option value="1">Mr</option>
								<option value="1">Mrs</option>
								<option value="1">Mss</option>
							</select>
							<?php //echo form_error('title'); ?>
						</div>
						<div class="form-group">
							<label for="first_name">First Name <span class="required">*</span></label>
							<input type="first_name" class="form-control" id="first_name" name="first_name" placeholder="First Name" value="<?php echo set_value('first_name'); ?>" required="required">
							<?php echo form_error('first_name'); ?>
						</div>
						<div class="form-group">
							<label for="last_name">Last Name <span class="required">*</span></label>
							<input type="last_name" class="form-control" id="last_name" name="last_name" placeholder="Last Name" value="<?php echo set_value('last_name'); ?>" required="required">
							<?php echo form_error('last_name'); ?>
						</div>
						<div class="form-group">
							<label for="phone">Phone </label>
							<input type="text" class="form-control" id="phone" name="phone" placeholder="Phone" value="<?php echo set_value('phone'); ?>" required="required">
							<?php //echo form_error('phone'); ?>
						</div>
						<div class="form-group">
							<label for="mobile">Mobile </label>
							<input type="text" class="form-control" id="mobile" name="mobile" placeholder="Mobile" value="<?php echo set_value('mobile'); ?>" required="required">
							<?php //echo form_error('mobile'); ?>
						</div>

					</div><!-- /.box-body -->

					<div class="box-footer">
						<button type="submit" class="btn btn-success">
							<span class="glyphicon glyphicon-saved"></span> Submit
						</button>
					</div>

				</div><!-- /.box -->

			</div><!--/.col (left) -->
			<!-- right column -->
			<div class="col-md-6">
				<!-- general form elements disabled -->
				<div class="box box-warning">

					<div class="box-body">
						<div class="form-group">
							<label for="dob">Date of Birth (dd/mm/yyyy)</label>
							<input type="text" class="form-control" id="dob" name="dob" placeholder="" value="<?php echo set_value('dob'); ?>" required="required">
							<?php //echo form_error('dob'); ?>
						</div>
						<div class="form-group">
							<label for="gender">Gender </label>
							<select name="gender" class="form-control">
								<option value="Male">Male</option>
								<option value="Female">Female</option>

							</select>
							<?php //echo form_error('title'); ?>
						</div>
						<div class="form-group">
							<label for="address">Address</label>
							<textarea class="form-control" rows="7" name="address"><?php echo set_value('address'); ?></textarea>
						</div>
						<div class="form-group">
							<label for="password">Password <span class="required">*</span></label>
							<input type="password" class="form-control" id="password" name="password" placeholder="Password" required="required">
							<?php echo form_error('password'); ?>
						</div>
						<div class="form-group">
							<label for="conf_password">Confirm Password <span class="required">*</span></label>
							<input type="password" class="form-control" id="conf_password" name="conf_password" placeholder="Confirm Password" required="required">
							<?php echo form_error('conf_password'); ?>
						</div>
						<div class="form-group">
							<label for="active">Active <span class="required">*</span></label>
							<select name="active" class="form-control">
								<option value="1">YES</option>
								<option value="0">NO</option>
							</select>
							<?php //echo form_error('title'); ?>
						</div>

					</div><!-- /.box-body -->
				</div><!-- /.box -->
			</div><!--/.col (right) -->
		</div>
		<!-- /.row -->
	</section><!-- /.content -->
</form>